Care Home: Shafto House

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What the care home does well The home makes sure that all prospective service users and their families have the information they need before deciding to move in. Good healthcare arrangements are available with district nurses, GP`s and other healthcare specialists visiting the home when requested.The quality of food is good and service users likes and dislikes are taken into account and they can choose from a number of options on the menu, what they would like to eat. The staff team are caring, committed and offer all service users the help they need in a dignified manner, with good medication procedures used to ensure service users are kept safe. All staff receive good training and this helps people to know that they will be well looked after, regardless of their various needs. The home is clean and generally well looked after and provides a comfortable and homely place for service users to live in. Service users and their families have made many positive comments about the home and the service they receive and feel confident that if they have a concern or a complaint, it will be dealt with effectively. What has improved since the last inspection? The acting manager and another member of staff visit prospective service users to complete an assessment, which ensures that the home knows it can meet all of the needs before a service user moves in. Menu choices have improved, with service users able to state their likes and dislikes when planning new menus. There has been some re-decoration and new carpets laid in some areas of the home. All staff employed in the home have completed alerter training, so that they are aware of what to do should an abusive situation happen or be suspected. This helps to keep people safe. What the care home could do better: When an assessment visit is made to a person who is thinking of coming into care, the information should be recorded before an admission date is arranged. The service users would benefit from information on planned activities, which would help them plan if they want to be involved in them. All activities taking place should be fully recorded. Permanent management arrangements should be in place so that staff receive the guidance they need to meet all the service users needs. CARE HOMES FOR OLDER PEOPLE Shafto House Shafto Way Newton Aycliffe Co Durham DL5 5QR Lead Inspector Mrs Eileen Hulse Key Unannounced Inspection 27th May 2008 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shafto House Address Shafto Way Newton Aycliffe Co Durham DL5 5QR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01325 312961 F/P 01325 312961 www.durham.gov.uk Durham County Council Care Home 30 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (29) of places Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2006 Brief Description of the Service: Shafto House is a detached building standing in its own grounds within a housing estate, it is a local authority care home providing personal care for up to 30 older people. All of the accommodation is single occupancy and on ground floor level. The home is divided into three semi-independent living units and each unit has its own dining room, lounge and a kitchen where drinks and snacks can be prepared. Meals are prepared in the homes main kitchen, which also provides meals for the adjoining day centre. There is a garden for residents to enjoy in fine weather and car parking for visitors and staff is at the rear of the building. Shafto House is situated in Newton Aycliffe close to the town centre and within easy reach of public transport. The home cannot provide nursing care. The weekly fees are £432:00 and additional charges are made for personal items such as personal items, hairdressing, and toiletries. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. How the inspection was carried out. Before the visit: We looked at: • Information we have received since the last visit on 24th May 2006 • The annual review of the service that was carried out on 11/04/08 • How the service dealt with any complaints & concerns since the last visit • Any changes to how the home is run • The provider’s view of how well they care for people • The views of people who use the service, their relatives and staff. The Visit: An un-announced visit was made on 27th May 2008. During the visit we: • Observed staff practice and talked with people who use the service, relatives, staff and the acting manager • looked at information about the people who use the service & how well their needs are met • looked at other records which must be kept • checked that staff had the knowledge, skills & training to meet the needs of the people they care for • looked around the parts of the building to make sure it was clean, safe & comfortable • checked if any improvements had recently been made. We told the acting manager what we found. What the service does well: The home makes sure that all prospective service users and their families have the information they need before deciding to move in. Good healthcare arrangements are available with district nurses, GP’s and other healthcare specialists visiting the home when requested. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 6 The quality of food is good and service users likes and dislikes are taken into account and they can choose from a number of options on the menu, what they would like to eat. The staff team are caring, committed and offer all service users the help they need in a dignified manner, with good medication procedures used to ensure service users are kept safe. All staff receive good training and this helps people to know that they will be well looked after, regardless of their various needs. The home is clean and generally well looked after and provides a comfortable and homely place for service users to live in. Service users and their families have made many positive comments about the home and the service they receive and feel confident that if they have a concern or a complaint, it will be dealt with effectively. What has improved since the last inspection? What they could do better: When an assessment visit is made to a person who is thinking of coming into care, the information should be recorded before an admission date is arranged. The service users would benefit from information on planned activities, which would help them plan if they want to be involved in them. All activities taking place should be fully recorded. Permanent management arrangements should be in place so that staff receive the guidance they need to meet all the service users needs. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users are given the information they need to make an informed choice about moving into the home. EVIDENCE: Referrals are made to the home from care managers and families. All prospective service users have an individual assessment that is completed before moving into the home by the care manager, who will then supply the home with a personalised care plan prior to admission. This helps the home to prepare a plan of care for the person moving in. The home manager or deputy then visits the prospective service user in hospital or at home to assess if the service can meet the persons needs. However, the home pre admission assessment details are not completed following the visit. They are completed after the person has moved into the Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 10 home, which makes it difficult to fully assess if the person is suited to that particular home and if their needs can be met. Following the assessment, the home will write to the person stating they either can or cannot provide a service to them and the reasons for this. A date for admission is then arranged that is suitable to both the service user and the home. Prospective service users are invited to visit the home to have a look around and some people decide to spend some time there to meet other service users and to have a meal. An overnight stay is also available. This helps the person to decide if they would like to live there. The service user lives in the home for 6 weeks to see if they like it and for the home to ensure they can meet the needs. A review meeting is then held between representatives of the home, service user, family and care manager. There is plenty of information about the service made available to everyone so that service users know what medical and personal care service they can expect to receive. There is a bureau in the main entrance that has leaflets on various topics, such as meeting the needs of carers and views about adult social services and how to complain about a service. Comments made from service users included: ‘I have lived here a long time and I have a nice bedroom.’ ‘The home is very good.’ Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have regular access to healthcare professionals and the medication system helps to ensure that service users are kept safe which in turn promotes their welfare. EVIDENCE: All service users have a plan of care that is followed by staff to meet the care needs. These care plans are organised and although bulky, act as triggers and prompts to monitor, evaluate and act on changes in service users’ needs or circumstances. The range of recording documents contain sufficient information that staff can follow. However in some instances there were no dates, so it is unknown if the records are current and no signatures throughout. Information that will tell staff how to meet the needs identified, is contained in an array of documents, which staff are familiar with and use effectively. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 12 However, the systems and processes for recording the delivery of care to service users look complex and therefore needs to be confidently explained and understood by all staff and new staff, to ensure appropriate care is given. Action plans are monitored and evaluated. These are being further developed, particularly providing more detail with regards to outcomes fro service users. The home continues to use daily records, recorded in a book. Individualised recording pages are used, which are, upon completion, removed and placed in the service user’s care plan. The home uses a monitored dosage medication system and these are delivered to the home from the pharmacy on a monthly basis. At the same time any unused or unwanted drugs are collected are returned to the pharmacy. MAR (medication administration document) sheets and the returned drugs book were signed and up to date. Controlled drugs are in use and recorded in a controlled drug book and there is a medical fridge in use for medicines that need to be stored under a certain temperature. All staff responsible for administering medication have completed the ‘Safer Handling of Medication’ training. Comments from service users and families included: ‘One of the staff go with me if I have to go to the hospital’ ‘The staff make sure we see nurses and doctors when we need them’ ‘If I need the Doctor he is called in’ ‘When I came to live here I kept the same Doctor’ ‘Its great when I get my feet done, it makes me feel better’ ‘I like to spend time in my room but it seems they want me in the lounge during the morning’ Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users maintain contact with friends and family, while daily living for service users is flexible, to give them some choice in their daily lives. However, while the home provides some activities, it would benefit from an activity coordinator to organise structured activities, leaving the care staff to carry out other roles. Service users are offered and receive a varied and nutritious diet and this helps to promote their health and well being. EVIDENCE: A member of an organisation called “Create” comes into the home once every two weeks to give staff ideas for providing various activities. The home does not have an activities co-ordinator but two members of staff have been nominated to organise and provide activities two or three times in the week. This is not a planned strategy but rather relies upon the staff members having time within their existing responsibilities to do activities. Consequently there is Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 14 no consistency in the organisation of the activities. However a range of activities do take place. There is not an activities programme as activities are decided on each day and therefore this does not inform people in advance of the events taking place. In discussions with service users, they commented:‘I would like to go out but we don’t go anywhere’ ‘I get my newspaper delivered everyday and I am quite happy living here’ ‘I like to sit outside when it’s nice weather’ ‘I have lived here for four years and get on well with the staff, they are all nice’ ‘Sometimes I wish there was more going on as it gets on my nerves having nothing to do all day’ ‘I watch the telly a lot’ Previously there were no activity records available that would describe in detail who had attended the activities, what the outcome of the activity was and who had refused to take part in them. This has now been remedied. The outcomes for service users participating in activites is recorded. Lunch was taken with the service users in one of the three dining rooms. The dining areas are arranged to seat six to nine people in total. Tables were well set with tablecloths, serviettes and condiments. Each service user was asked what they wanted to eat from a choice of two meals and what vegetables they wanted and people requiring help with their meal were given assistance from staff in a sensitive and dignified way with sufficient time to sit and enjoy their meal without being hurried. People were also offered second helpings of food. During the lunch service users made the following comments: ‘The food’s alright in here and we get plenty of it.’ ‘We get good choices regarding the food.’ ‘If it’s something somebody doesn’t like they can always have something else.’ ‘Staff will bend over backwards to give us what we want at mealtimes.’ Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the information they need to make a complaint and are confident their complaints will be dealt with effectively. Good adult protection procedures are available that help to protect service users should an abuse situation arise or be suspected. EVIDENCE: The home has a detailed complaints procedure that is made available to each service user and their representative and it is also located within a number of documents accessible to service users and their relatives. It is written in the Statement of Purpose and leaflets are attached to the home notice board. People are given this information prior to admission and further copies can be obtained from the home so that the information is always accessible. Complaints made about the service are documented, including the nature of the complaint, who the complaint was made by, date and signature of person accepting the complaint but it does not include the timescale for action and following the investigation if the complainant was happy with the outcome. All service users who were asked if they knew how to make a complaint said they did know and stated that should they have a concern or a complaint they were confident it would be dealt with and their comments included: Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 16 ‘I have no complaints and if I did I would see the girls’ ‘I’m happy here and get well looked after, don’t need to complain’ ‘If I go to the office about something it is dealt with immediately’ ‘Nothing to complain about everybody is great’ The safeguarding procedures are in the home and accessible to the staff team. All of the staff regardless of their roles within the service have received up to date safeguarding and alerter training from Durham County Council. The council procedure also says that if any service user requires an advocate then one will be appointed. There have been no safeguarding issues reported to the CSCI or to the home since the last inspection and no complaints about the service have been received by the CSCI. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good standard of accommodation offering service users a comfortable, homely and safe place to live. EVIDENCE: Shafto House is a detached building standing in its own grounds within a housing estate. All of the accommodation is single occupancy and on ground floor level. The home is divided into three semi-independent living units and each unit has its own dining room, lounge and a kitchen and there are a variety of communal areas for service users to choose from and bedrooms are furnished and personalised with photographs, ornaments and other personal possessions to suit their individual choice and tastes. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 18 Some improvements have been made to the home. The dining rooms and some of the bedrooms have been re-decorated and new carpets have been laid in the smoking lounge and in one of the dining rooms. Painting and decorating throughout the building is carried out, as and when it is required, by the home’s handyman who works in the home two and a half days a week. A maintenance book identifies minor works to be carried out or items to be replaced. At the time of the visit, the handyman was present in the home and addressing some of the issues identified in the records. Most of the staff team have completed ‘Infection Control’ training. Domestic staff work hard to keep the home to a good standard of cleanliness and free from odours. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 17, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staffing levels, competent and qualified staff and robust recruitment procedures ensure that service users needs are met and they are kept safe from potential harm. EVIDENCE: There are good staffing levels and the numbers of staff on duty were confirmed by the staff rota. At the time of the visit there were six care assistants and two senior care staff on duty throughout the day. All of the care staff apart from three staff holds an NVQ level 2 in care. Staff are very positive about the service and in discussions with some of the staff on duty they made the following comments: ‘It’s a nice place to work’ ‘We get lots of training opportunities’ ‘I feel I am well supported to do my job’ The home has a policy and procedure on staff recruitment that is used when the home need to replace staff. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 20 The acting Manager was able to explain in detail the process that is used from sending out an application form to the point of recruiting a new member of staff. A sample of staff personal files were looked at, they were up to date and all the necessary checks and documentation were in place, including two references, Criminal Records Bureau check, past work history, photograph, qualifications held and personal documentation. Individual staff supervision also takes place regularly and the records relating to supervision are also held on the personal files. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. While management arrangements are not in place at the home, nevertheless, staff receive the leadership and direction they need so that they can consistently meet the needs of service users. Staff follow safe working practices that promote a safe environment for service users, staff and visitors. EVIDENCE: Although the acting manager has held this role for the last sixteen months she has not been registered as manager with the Commission for Social Care Inspection. However she is supported by the previous manager of the service and her line manager. Confirmation has since been received from the local authority to confirm that an application to register the manager will been sent to us within three months. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 22 She has held various posts within the home, covering a range of domestic, kitchen and care duties for over twenty-three years. She has completed NVQ level 2 in care, holds the D32/33 Assessors award and NVQ level 3 in management. The acting manager continues to update her knowledge and skills, attending various courses, such as all mandatory training, Dementia care and infection control and is currently completing NVQ level 4 in management. Observation showed that staff followed safe working practices at all times. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP12 Regulation 16 Requirement Activities should be structured and records kept to make sure they meet the expectations of all service users. The home needs to have a registered manager appointed. Timescale for action 01/09/08 2 OP31 12 31/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations The homes pre admission assessment details should be recorded before the service user is admitted so the home DS0000031217.V364119.R01.S.doc Version 5.2 Page 25 Shafto House can know if the needs can be met. Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Shafto House DS0000031217.V364119.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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